In the history of oprthalmic surgery the problem of cataract removal has been a constant concern and surgical techniques have progressed through the years to improve the effectiveness of cataract removal and to lessen the pain and discomfort for the patient. Naturally if cataracts are permitted to remain in the eye they cause blurred vision and eventual blindness.
Cataracts were once removed with forceps through a 180 degree incision which was uncomfortable for the patient and required a long recovery period of many weeks. The same is true for the cryogenic probe procedure which is used by many surgeons today. This procedure also requires a very large incision.
After the cataract is removed it is under certain conditions an advisable procedure to insert an artificial lens and mount the lens in the eye. With the large incision this caused no extreme difficulty for the surgeon since the assembled lens and supporting structure can be passed through the large incision and mounted in the eye in conventional fashion, such as by engagement with surrounding eye tissue or by suturing the supporting structure in position.
I have developed a unique procedure for removal of cataracts which has proved to be an extremely advantageous over either of the two above discussed techniques. By use of an ultrasonic drill I am able to dissolve, emulsify and remove a cataract through a two or three millimeter incision. The instrument finally perfected utilizes a sharp-tipped drill, vibrating at 40,000 strokes per second. With each miniature tap, the drill's tip dissolves a minuscule fragment of the lens, which is simultaneously sucked away by a pump. No longer is it necessary to provide an incision of 180.degree., a small two or three millimeter incision is sufficient for permitting the shock tip drill to reach the proper location within the eye.
The result is a much faster procedure, causing less patient discomfort, and permitting the patient to return to ordinary activity much sooner. My patients resume their normal lives the day following the operation, whereas, after the traditional operation, the patient convalesces for up to 6 weeks.
My technique requires a single suture that remains permanently and harmlessly in the eye of the patient. The standard technique requires six to eight stitches. The operation is performed under a microscope. After the incision is made, the tiny drill is inserted into the chamber that separates the cornea from the lens. When the drill makes contact with the lens, it is automatically activated and begins dissolving and sucking out the cataract. Depending upon the age of the patient, the entire drilling process entends no longer than from under a minute to five minutes.
Naturally with only a 2 millimeter incision, it is more difficult to insert an intraocular lens through the incision to mount it in the eye after the cataract operation is completed. Accordingly, there is obviously room for improvement in the types of intraocular lenses manufactured for use and also in the technique for mounting the lenses in the eye.